中国组织工程研究

中国组织工程研究 ›› 2016, Vol. 20 ›› Issue (51): 7634-7641.doi: 10.3969/j.issn.2095-4344.2016.51.005

• 肌肉肌腱韧带组织构建 tissue construction of the muscle, tendon and ligament • 上一篇    下一篇

保留残端与不保留残端重建前交叉韧带腱骨愈合情况比较

张  磊1，2，岳  娜3，张太良4，谢崇新2，白靖平1   

  1. 新疆医科大学附属肿瘤医院，1骨与软组织科，3病理科，新疆维吾尔自治区乌鲁木齐市  830011；2新疆武警兵团指挥部医院骨科，新疆维吾尔自治区乌鲁木齐市  830063；4新疆医科大学第一附属医院骨科中心，新疆维吾尔自治区乌鲁木齐市  830054
  • 出版日期:2016-12-09 发布日期:2016-12-09
  • 通讯作者: 白靖平，博士，教授，博士生导师，新疆医科大学附属肿瘤医院骨与软组织科，新疆维吾尔自治区乌鲁木齐市 830011
  • 作者简介:张磊，男，1979年生，新疆维吾尔自治区阿勒泰市人，汉族，新疆医科大学在读博士，主要从事骨与关节损伤研究，现工作单位为新疆武警兵团指挥部医院骨科。
  • 基金资助:

    新疆生产建设兵团自然科学基金资助项目(2015AD004)

Tendon-bone healing after acute anterior cruciate ligament reconstruction with versus without remnant preservation

Zhang Lei1, 2, Yue Na3, Zhang Tai-liang4, Xie Chong-xin2, Bai Jing-ping1   

  1. 1Department of Bone and Soft Tissue, 3Department of Pathology, the Affiliated Tumor Hospital of Xinjiang Medical University, Urumqi 830011, Xinjiang Uygur Autonomous Region, China; 2Department of Orthopaedics, Hospital Affiliated to Xinjiang Production and Construction Corps Headquarters of Chinese People’s Armed Police Forces, Urumqi 830063, Xinjiang Uygur Autonomous Region, China; 4Department of Orthopaedic Surgery, the First Affiliated Hospital of Xinjiang Medical University, Urumqi 830054, Xinjiang Uygur Autonomous Region, China
  • Online:2016-12-09 Published:2016-12-09
  • Contact: Bai Jing-ping, M.D., Professor, Doctoral supervisor, Department of Bone and Soft Tissue, the Affiliated Tumor Hospital of Xinjiang Medical University, Urumqi 830011, Xinjiang Uygur Autonomous Region, China
  • About author:Zhang Lei, Studying for doctorate, Department of Bone and Soft Tissue, the Affiliated Tumor Hospital of Xinjiang Medical University, Urumqi 830011, Xinjiang Uygur Autonomous Region, China; Department of Orthopaedics, Hospital Affiliated to Xinjiang Production and Construction Corps Headquarters of Chinese People’s Armed Police Forces, Urumqi 830063, Xinjiang Uygur Autonomous Region, China
  • Supported by:

    the Natural Science Foundation of the Xinjiang Production and Construction Corps, No. 2015AD004

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被引次数

2

摘要：

文章快速阅读：

文题释义：
保留残端重建前交叉韧带：前交叉韧带断裂后胫骨残端多能存在较长时间，以往为了手术操作方便和视野清晰，常将其完全清除掉。然而现在发现前交叉韧带富含血管、神经可能会对移植物的重建有所帮助，所以保留残端重建前交叉韧带成为了一些学者研究的热点。目前不少学者认为保留残端重建前交叉韧带的优势是：①促进移植腱血管化，加快移植腱再韧带化；②促进膝关节本体感觉恢复，提高膝关节功能；③促进移植物腱骨愈合。
腱骨愈合：移植物在体内重塑包括2个部分：一是关节腔内段部分，二是骨隧道内段部分。移植腱与骨的愈合情况是重建手术成功与否的重要标志。有学者对交叉韧带翻修手术的原因做了统计，原因主要是再次创伤、手术技术欠佳和生物混杂因素，其中生物混杂因素所占比例最高，将近50%，而腱骨愈合不良又占生物混杂因素的30%，所以备受国内外学者关注。
摘要
背景：保留残端重建能够促进腱骨愈合，但目前的研究仅停留组织学水平。从分子生物层面报道保残重建对促进腱骨愈合作用机制的研究国内外尚未见报道。
目的：探讨保留残端重建前交叉韧带对腱骨愈合的机制。
方法：72只新西兰兔随机分为不保残组、牵张保残组和残端鞘内重建组，各24只，分别采取不保残、牵张保残和残端鞘内重建方法进行急性期双膝前交叉韧带重建。
结果与结论：①苏木精-伊红染色结果显示，牵张保残组和残端鞘内重建组兔腱骨愈合优于不保残组，残端鞘内重建组优于牵张保残组；②实时荧光定量PCR结果表明，牵张保残组和残端鞘内重建组兔移植腱周边骨组织中骨保护素 mRNA表达水平及骨保护素/RANKL比值大于不保残组，且残端鞘内重建组兔移植腱周边骨组织中上述指标大于牵张保残组，而RANKL mRNA表达水平小于不保残组；③结果提示2种保留残端重建前交叉韧带方法都能够促进腱骨愈合，其中以残端鞘内重建最明显，作用机制可能与早期上调骨道中骨保护素mRNA，下调RANKL mRNA有关。

中国组织工程研究杂志出版内容重点：组织构建；骨细胞；软骨细胞；细胞培养；成纤维细胞；血管内皮细胞；骨质疏松；组织工程
ORCID: 0000-0003-2299-6243(白靖平)

关键词: 组织构建, 组织工程, 重建前交叉韧带, 保留残端；腱骨愈合, 骨保护素, 细胞核因子κB 受体活化因子配体

Abstract:

BACKGROUND: Reconstruction with remnant preservation can enhance tendon-bone healing. However, the study limits on the histological level, and there is a lack of research based on the modular biological level.
OBJECTIVE: To investigate whether anterior cruciate ligament reconstruction with remnant preservation can enhance tendon-bone healing.
METHODS: Seventy-two New Zealand rabbits were randomly allocated to three groups (n=24 per group), followed by cruciate ligament reconstruction without remnant (group A), with remnant preservation (femoral tensioning and augmented suture) (group B) and with remnant preservation (graft passing remnant anterior cruciate ligament sheath) (group C), respectively.
RESULTS AND CONCLUSION: Hematoxylin-eosin staining showed that the tendon-bone healing in the groups B and C surpassed that in the group A, and group B was better than group C. Real-time PCR revealed that the expression level of osteoprotegrin mRNA and the osteoprotegrin/receptor activator of nuclear factor-κB ligand (RANKL) ratio were greater in the groups B and C than in the group A, and highest in the group C, while the expression levels of RANKL mRNA in the groups B and C were lower than that in the group A. In conclusion, these two kinds of anterior cruciate ligament reconstruction methods with remnant preservation can enhance tendon-bone healing, which have obtained most obvious achievements in the anterior cruciate ligament reconstruction in the graft passing anterior cruciate ligament remnant sheath that may be related to the up-regulation of osteoprotegrin mRNA and down-regulation of RANKL mRNA.

中国组织工程研究杂志出版内容重点：组织构建；骨细胞；软骨细胞；细胞培养；成纤维细胞；血管内皮细胞；骨质疏松；组织工程

Key words: Tendons, Anterior Cruciate Ligament, Tissue Engineering

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